Provider Demographics
NPI:1023709649
Name:BURTIS, LINDSAY
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:COYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 ASHFORD CT
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-4439
Mailing Address - Country:US
Mailing Address - Phone:215-582-7529
Mailing Address - Fax:
Practice Address - Street 1:101 ASHFORD CT
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-4439
Practice Address - Country:US
Practice Address - Phone:215-582-7529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health